Strokes affecting the right side of the brain are well-known to cause a cluster of symptoms collectively known as spatial neglect. If you have spatial neglect, you may be inattentive or utterly unaware of objects, stimuli, and even people on the left side of your body. This condition can be inherently frustrating. And, it can cause longer hospital stays and increased difficulty with rehabilitation. Treatments with a lasting impact have been difficult to come by. However, a recent approach known as prism adaptation has shown a great deal of promise. Prism adaptation entails wearing goggles with prism lenses. These lenses shift objects up to 12 degrees to the right while working to perform a hand-eye coordinated task. After removing the prism glasses following the exercise, some patients have demonstrated an improvement in their symptoms. However, testing so far has revealed that not all individuals seem to benefit from the therapy.
Does the location of the stroke determine who benefits?
Researchers from the US designed a randomized control trial to test whether the location of the stroke predetermines which patients benefit from prism adaptation. They recruited nineteen participants who had experienced a right-brain stroke between 9 and 50 days ago. Some participants were randomly assigned to either a 10-day course of once-daily prism adaptation treatment. The others were assigned to a control group receiving standard care.
Patients in the prism group received prism adaptation treatment for about 15 to 20 minutes once a day for ten days over the span of 2 weeks in addition to standard therapy. The treatment entailed wearing prism goggles as described above. Patients had to use a pen in their right hand to mark a line or circle stimulus on a piece of paper. Standard care for the control group included three hours of occupational, physical, and speech-language therapy every day. Additionally, the patients worked with recreational therapists, psychologists, and social workers. They received rehabilitation-certified nursing care and other routine medical care. Finally, the study team also precisely mapped the areas of each participant’s brain affected by stroke.
Does prism adaptation work for everyone?
The researchers found prism adaptation therapy improved the ability of spatial neglect patients to perform everyday tasks. However, there was one caveat. The prism adaptation only strongly benefitted patients whose stroke was predominantly in the frontal lobe of the brain. In contrast, the location of the stroke did not alter the effect of standard therapy in the control group in any way. In addition to the positive findings associated with prism adaptation, these findings also indicate damage in the frontal lobe is at least partly responsible for your difficulty performing everyday tasks after a right-sided stroke. If you are having trouble with symptoms of spatial neglect after a frontal lobe stroke, prism adaptation may offer a good deal of upside. It is inexpensive and non-invasive. It doesn’t require a lot of training. And, it can even work for patients who are unaware they are experiencing symptoms of neglect!
The lead author of the original article is Dr. Kelly M. Goedert, Department of Psychology, Seton Hall University, South Orange, NJ, USA.